· Dr. Carla Shatz, professor of biology and neurobiology, Stanford University
· Dr. Alfred Sommer, professor of epidemiology, ophthalmology, and international health; dean emeritus, School of Public Health, Johns Hopkins University; Albert Lasker Clinical Medical Research Award
· Dr. James Tsai, president, New York Eye and Ear Infirmary of Mount Sinai
Finally comes the end point of all this effort by so many immensely talented people: galvanizing the attention and focusing the efforts of those who can actually answer my Call. And here again, thinking big, going deep, and daring to risk the unknown has served the End Blindness campaign more than well.
In 2017, almost five years after we had first announced the prize, I was invited to speak to 4,000 members of the International Society for Stem Cell Research gathered at the Boston Convention Center—heady territory for a guy with no degrees in the sciences. But the first time I knew for certain that this critical part of the larger plan was working came three years earlier when I delivered the keynote address at the March 2014 plenary session of the Lasker/IRRF (International Retinal Research Foundation) Initiative for Innovation in Vision Science, led by John Dowling, professor of neuroscience at Harvard University and a member of our scientific advisory board.
Leading vision scientists from around the world, representing a variety of specializations, had gathered in a single room at the Janelia Research Campus of the Howard Hughes Medical Institute. To me, this was the chance of a lifetime to further my long-held belief that a cooperative approach among investigators “across all disciplines” will best get us to the ultimate goal. And I wasn’t going to waste it.
As with any great human endeavor, I told those gathered, our ultimate objective was transformative, not transactional. Our Call was for a complete and unified physiology of vision and neural function—one that recognized that individual investigations were the sine qua non of medical and scientific research, but not its finish line.
To end blindness, I said, we have to dream big first—we have to imagine a world in which we know everything about how vision works. The role of every muscle, every fluid, every tissue and cell type and construction, every gene, every protein, every inhibitory function, every neuron grouping, every chemical and electrical interaction along the neural pathway, every interaction among elements along the cascade of vision, every mechanism of natural repair, and every structural gap in natural repair. How nerve tissue grows and assumes its function. What mechanism—or lack of mechanism—inhibits damaged nerve tissue from regenerating, contrasted with what routinely happens beneficially when tissue in, say, the skin is damaged. Critically, we also have to know how all these elements function together. And then we have to make it all happen. We have to make the dream come true. Then and only then will I have truly fulfilled my Call.
I told the audience that I knew this is not the usual model applied to this sort of scientific inquiry. Physics models tend to start big and then bore down—think of Einstein’s Theory of Relativity or Heisenberg’s Uncertainty Principle—while medicine traditionally builds breakthroughs from the bottom up. But, I asked, can anyone here dispute the potential high clinical value that lies within a model such as I was proposing? Or the value of unlocking such answers? The value for prevention, the value for diagnoses, the value for treatments—the value most of all for those who might be able to do something they never rationally believed they would do again: see, be unblind.
I admit to holding my breath somewhat as I ended. At one level, I wondered if JFK’s call for a moon landing within the decade had left jaws agape at Cape Canaveral and elsewhere: What is this nutcase president thinking? At a deeper level, though, I knew that if my holistic, top-down iteration of the Call fell flat before an audience of all-star researchers, I was most likely headed back to the drawing board with no idea where to turn next. Happily—make that joyfully—that didn’t happen. My concept was very positively, even enthusiastically received at Janelia that evening.
One of the investigators in the audience did voice skepticism about the wisdom of substituting a physics-style model for the medical approach to vision. In response, I offered an analogy with automotive care. No sensible person would rely on a car mechanic who said, “I can locate and fix any problem—so long as it doesn’t involve the electrical system or the computer module.” A master mechanic can assess and repair across the entire system, just as particle physicists can model the existence of unseen particles or the influence of unknown forces.
I have no idea whether that was sufficient to turn the skeptic around, but if there is some insurmountable barrier standing between us and the complete and integrated array of whatever knowledge we might glean and gather, no one has yet shown that such an ultimate wall exists, theoretically or otherwise. Indeed, I would argue exactly the opposite: the wall is there only because we let it be. And that, as I wrote earlier, is maybe the greatest advantage of being blind: we recognize neither walls nor horizons. Our expectation is infinite.
I do know for certain that we are ever closer to the finish line of ending blindness. Whether we cross by or before December 14, 2020, or at some later date, is almost immaterial, especially now that Johns Hopkins University has matched Sue’s and my audacity with an audacious act of its own: the creation of the Sanford and Susan Greenberg Center to End Blindness, to carry on my tikkun olam even should the prize itself disappear from memory. Between the two—our prize and the new Johns Hopkins center—blindness doesn’t have a chance.
I may not be around to witness it, but before this century is out, blindness will disappear from the long roster of human injustices. And this, too, will be a giant
